Do Running Shoes Cause Injury? Our Response

This entry was posted on January 12, 2010 by Sir Isaac.

Newton

There's a great discussion going on over at RunnersWorld.com about a new study that links running shoes to injuries here. Here are a few thoughts that our Director of Education, Ian Adamson, would like to add to the dialogue:

There are several on-going, multi-year studies at Harvard, MIT and the University of Newcastle (AUS) that are looking at injury related to footwear. Harvard department of Anthropology is about to publish a study that dissects unshod human running gait and injury (or lack thereof.)

If the only injury from running shoes is Achilles tendinitis, is the implication that the other "running related injuries" such as neuromas, plantar fascitis, blisters, bunions and joint problems would be present in if people didn't run?

How Shoe Geometry Affects Running Gait

I'm on the front line seeing runners who present with all of the above and more, and the vast majority are treatable with appropriate shoes (the closer a shoe reflects the geometry of the foot the better, although protection from man-made and unnatural surfaces is prudent), especially a lower heel/ramp angle combined with proper form coaching.

There is no doubt in my experience (running competitively since 1973, 12 years as a professional athlete, 10 years in the shoe industry, 10 years as a bio-mechanical engineer) that lifted heels in running shoes introduce an unnatural geometry that interferes with our natural (and injury protective) gait.

Ramp Angle Comparison in Minimalist Shoes

It would take a lot to convince me that strapping 1/2 to 1" foam to your heel doesn't alter your stride. If you cut virtually any running shoe lengthwise you can see the drop from heel to the ball of the foot. The Nike Shox as noted above is one of the worst offenders. It used to be that 24 mm heel height (1 inch) and 12 mm (1/2") forefoot was standard, but those numbers have changed dramatically in the last few years. Some popular running shoes are up to 35 mm in the heel.

The old standard drop (24-12) gives an 8% grade in a Men's US size 9 shoe, but most are now far in excess of that, up to 15% in some cases. An 8% road grade (rise/ run as a %) is where most states give truckers a warning. Racing flats can be better in terms of being more level, but virtually none are actually level. The best on the market are:

It is interesting to note that some perceived "flat" shoes are not: Nike Free 5.0 (10 mm/6.7%), Nike Zoom Streak XC (11 mm/7.3 %), Nike Luna Racer (12 mm/8.0%), Brooks T6 (13 mm/8.7%). On the other end of the spectrum, the Brooks Beast has a 16 mm drop and 10.7% grade.

My personal experience: ran track and cross country barefoot and injury free through high school. Ran in Dunlop Volley tennis shoes through college (no heel lift http://www.volleys.com.au/flash/index.html), injury free. Was given a "modern" running shoe with a heel lift by a sponsor in 1989 and sustained my first running related injuries. Started back with level shoes again in 2007 (Newton) and viola, injuries gone.

What do you think of the NB 790 in terms of heel-to-toe drop? Another shoe you should look into is the Mizuno Wave Universe 3 flat. It weighs 3.5 ounces and is very flexible.

I currently do mileage in the Brooks Racer ST4 and intervals/racing in the Universes. I'm looking to replace the Brooks Racers with something that is a little less shoe, esp since I'm a midfoot/forefoot striker and don't need so much heel and esp. don't need the stability of the Racer ST4. Any suggestions would be appreciated. One thing about the 790 is that it looks like my feet would be warmer, and its freezing here.

I totally agree with the comments relating to injury. I ran without injury before the advent of modern shoes with stacks of cushioning and other technical details which insulate you from the surface you're running on. The result, I believe, is that these shoes encourage an unnatural gait and a tendency to enforced pummeling of the earth. As a result, especially at 20 miles plus, is feeling sore all the time and becoming progressively less graceful. I switched to Newtons as a leap of faith and now run faster and with some style! I've recommended them to two of my protege runners in my jogscotland group with great success in injury reduction. Newton design takes away many of the damaging effects of mainstream shoes and add a further dimension- an almost magical enhancement of natural, gravity defying,running. Glorious!

Another option I've found interesting is the Adidas Adizero Rocket.
Heel (16mm), Forefoot (10mm) according to info on The Running Warehouse. There's a drop, but much less than the typical running shoe.

So I've battled shin splints for years when my distace gets high. I visited with my local running store this week (Runners Corner - Orem, UT). They have become big proponents of both barefoot running and "zeroing" running shoes. They don't "zero" shoes themselves becasue of potential liability, but they recommended a local shoe repair shop that will cut the sole open and remove a wedge of foam from the heel tapered to the midfoot. I guess they have a lot of people doing it with great success.

I bought the NB MT100's. They have a 8mm Forefoot and a 18mm heel. They recommend that I need a 10mm wedge taken out to make them completely "leveled".

Ya that's a very good point. I didn't know too much about Newton's at the time. I just started researching the concept once it was suggested to me. I'm sure I'll end up trying Newton's soon. Seems like people all over the web really like them.

I think that I may just get 5mm pulled out of my MT100's to get used to a flatter shoe. Then I'll try Newton's next.

I have had progressive achilles pain after a long run. I cannot seem to shake it. I had been running with Newton's for a year before the extra long run so I don't attribute it to the shoe. Other than rest does anyone have a suggestion or any experience with achilles pain (both legs), the source and how to heal it?

Cary, Achilles pain is generally caused by pushing off too hard, so try relaxing back onto you heel more. The stretch loads the elastic recoil in your muscle and tendon and provides part of the propulsion in your stride. Also concentrae on lifting your foot rather than pushing off.

Cary, Achilles pain is generally caused by pushing off too hard, so try relaxing back onto you heel more. The stretch loads the elastic recoil in your muscle and tendon and provides part of the propulsion in your stride. Also concentrae on lifting your foot rather than pushing off.

Thanks for posting this. As a frequent barefoot runner, I find the largest impediment to transferring my smooth, barefoot running form to shoes is the height of the heel rise, or heel-toe drop. The bigger the drop, the harder it is to have good form. I can still run correctly, but it takes a conscious effort. I think the Kenyans have less problems because they grew up running barefoot. Perhaps when you grow up barefoot you can run in just about anything.

I love the cheap price and look of racing flats, but it's hard to find ones that are truly "flat." I like and own the Piranha's and the new Nike Streak XC 2. The Streak XC 2 has much less heel than the earlier version, and feels like it has less than the Prianha's, though I haven't measured. I know the Terra Plana Evo is out, but I'd like a wee bit of foam under my foot, please.

I'm starting to look at XC flats because they seem to be 'flatter' than road racing flats. I have Vibrams, of course, but there are certain things I don't like about them (and things I really do).

Please, somebody make a shoe with 10mm of foam and zero heel rise that weighs less than 6 oz! I would buy 5 pairs! 10 when the economy picks up!

How much does the Newton Racer weigh? From the photographs, it looks like a real clunker. Also, from the picture it looks like the Newton has a huge heel. I can't believe this would be a zero slope shoe. Also, what's with the Action/Reaction gimmick? Are we talking about the same shoe? Because from what I can tell, the Newton Performance Racer is the mother of all rip off heavy clunkers with a lame gimmick to sell to the unwitting.

I got out my ruler and did some measuring of my own shoes. First of all, to get slope, you have to measure length, which is different for different sizes. Also, you can't just measure from heel to toe, because the slopes are skewed on the first and last 10 mm or so. I measured from the middle of the heel to the ball of the foot.

I didn't cut my shoes down the middle so I had to choose one side to measure. I found that shoes that have stability can be quite different from one side to the other. (7.8% vs 9% in saucony Grid) I chose the inside to do my measuring. I wear a size 10.

My wife and I happen to have the same Saucony Grid A3. I couldn't believe it, but her women's size 7.5 had the same size heel and midfoot (30 mm and 15 mm) even though the length was different by like 25 mm. On the supposedly "same" shoe, she has a slope of 9% and mine is 8.3%. It just goes to show how lazy shoe companies are. They won't even maintain aspect ratios between shoe sizes.

I have a pair of "hurraches" made from 4mm Vibram (see www.invisibleshoe.com). No heel rise -- they are perfectly flat.

While rocks on the street still poke you a bit, they are a joy to run in. It took me only about 6 weeks to work up to my daily 5 mile run in them. I currently use the twice a week -- plan to move to 3 times when it is a bit warmer. I ran in fleece "tabi" socks in cold weather (a Japanese sock that is like a mitten for the foot.)